Mutations in Gamma-Secretase Subunit-Encoding PSENEN Underlie Dowling-Degos Disease Associated with Acne Inversa

Excess sebum rich in cholesterol and triglycerides can lead to hair loss through inflammation, with treatments like Ciclopirox shampoo, Benzoyl Peroxide shampoo, and Clindamycin gel recommended for managing conditions like seborrheic dermatitis and folliculitis. Pioglitazone is suggested for Lichen Planopilaris, while Omega-3s and reducing processed foods may improve sebum quality, though genetic factors play a significant role.

A 27-year-old male with diffuse hair loss, including the donor area, did not respond to finasteride, dutasteride, or minoxidil. He suspects his hair loss may be linked to a mild connective tissue disorder, possibly affecting the structural support of hair follicles, rather than being purely hormonal.

The user diagnosed with DUPA tried treatments like dutasteride, finasteride, RU58841, and minoxidil without success and is considering a hair system. They hope for a future cure, possibly with PP405, and others suggest options like scalp biopsy and SMP.

Pelage Pharmaceuticals' PP405 aims to treat hair loss by reactivating dormant hair follicle stem cells, showing promising results in early trials. The company plans to present their findings at the American Academy of Dermatology Annual Meeting in 2026.

The conversation discusses potential causes of pigmentation around hair follicles, suggesting sebum buildup, autoimmune conditions, or dermatitis. Treatments mentioned include finasteride, dutasteride, and an anti-inflammatory diet, with a recommendation to consult a doctor for a proper diagnosis.

PP405, a topical treatment, shows promise for hair growth by activating inactive follicles, with 66% of participants experiencing positive results. The treatment is well-tolerated and may proceed directly to Phase 3 trials, offering a potential alternative to minoxidil and finasteride.